{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,3]],"date-time":"2026-04-03T04:15:11Z","timestamp":1775189711066,"version":"3.50.1"},"reference-count":29,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2022,8,2]],"date-time":"2022-08-02T00:00:00Z","timestamp":1659398400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Instituto de Salud Carlos III (ISCIII)","award":["(PI19\/01263)"],"award-info":[{"award-number":["(PI19\/01263)"]}]},{"name":"FEDER Founds","award":["(PI19\/01263)"],"award-info":[{"award-number":["(PI19\/01263)"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Biology"],"abstract":"<jats:p>(1) Background: Abdominal adhesions are a common disease appearing after any type of abdominal surgery and may prolong surgical time and cause intestinal obstruction, infertility, or chronic pain. We propose the use of intraperitoneal collagenase to perform chemical adhesiolysis based on the pathophysiology and histology of adhesions. (2) Methods: We generated an adhesion model with intraperitoneal polypropylene meshes. Four months later, we evaluated the efficacy of the treatment in blinded form, i.e., 0.05% collagenase vs. placebo at 37 \u00b0C for 20 min. Protocol 1: Ten rats with ten mesh fragments, in which an attempt was made to remove the maximum number of meshes in a 5-min period. Protocol 2: Six rats with four mesh fragments in the sides of the abdominal cavity in which adhesiolysis was performed using a device that measures burst pressure. (3) Results: Protocol 1: 42% efficacy in the collagenase group versus 8% in the control group (p &lt; 0.013). Protocol 2: 188.25 mmHg (SD 69.65) in the collagenase group vs. 325.76 mmHg (SD 50.25) in the control group (p &lt; 0.001). (4) Conclusions: Collagenase allows for the safe and effective chemical adhesiolysis in this experimental model of adhesions.<\/jats:p>","DOI":"10.3390\/biology11081159","type":"journal-article","created":{"date-parts":[[2022,8,2]],"date-time":"2022-08-02T21:41:37Z","timestamp":1659476497000},"page":"1159","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Chemical Scalpel: An Experimental Collagenase-Based Treatment for Peritoneal Adhesions"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5174-2800","authenticated-orcid":false,"given":"Javier","family":"Barambio","sequence":"first","affiliation":[{"name":"Fundaci\u00f3n Jim\u00e9nez D\u00edaz University Hospital, 28033 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mariano","family":"Garc\u00eda-Arranz","sequence":"additional","affiliation":[{"name":"Fundaci\u00f3n Jim\u00e9nez D\u00edaz University Hospital, 28033 Madrid, Spain"},{"name":"Department of Surgery, Faculty of Medicine, Universidad Aut\u00f3noma de Madrid, 28029 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pedro Villarejo","family":"Villarejo Campos","sequence":"additional","affiliation":[{"name":"Fundaci\u00f3n Jim\u00e9nez D\u00edaz University Hospital, 28033 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6828-6031","authenticated-orcid":false,"given":"Juan Felipe V\u00e9lez","family":"V\u00e9lez Pinto","sequence":"additional","affiliation":[{"name":"Fundaci\u00f3n Jim\u00e9nez D\u00edaz University Hospital, 28033 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8558-1937","authenticated-orcid":false,"given":"Luz Vega","family":"Clemente","sequence":"additional","affiliation":[{"name":"Fundaci\u00f3n Jim\u00e9nez D\u00edaz University Hospital, 28033 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9384-3714","authenticated-orcid":false,"given":"Soledad Garc\u00eda","family":"G\u00f3mez-Heras","sequence":"additional","affiliation":[{"name":"Department of Human Histology, Faculty of Health Sciences, Rey Juan Carlos University, 28922 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6297-9347","authenticated-orcid":false,"given":"H\u00e9ctor","family":"Guadalajara","sequence":"additional","affiliation":[{"name":"Fundaci\u00f3n Jim\u00e9nez D\u00edaz University Hospital, 28033 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9369-2338","authenticated-orcid":false,"given":"Dami\u00e1n","family":"Garc\u00eda-Olmo","sequence":"additional","affiliation":[{"name":"Fundaci\u00f3n Jim\u00e9nez D\u00edaz University Hospital, 28033 Madrid, Spain"},{"name":"Department of Surgery, Faculty of Medicine, Universidad Aut\u00f3noma de Madrid, 28029 Madrid, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,8,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Ten Broek, R.P., Strik, C., Issa, Y., Bleichrodt, R.P., and van Goor, H. (2013). Adhesiolysis-related morbidity in abdominal surgery. Ann. Surg., 258.","DOI":"10.1097\/SLA.0b013e31826f4969"},{"key":"ref_2","first-page":"769","article-title":"Intra-abdominal adhesions: Definition, origin, significance in surgical practice, and treatment options","volume":"107","author":"Bruggmann","year":"2010","journal-title":"Dtsch. Arztebl. Int."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Herrick, S.E., and Wilm, B. (2021). Post-Surgical Peritoneal Scarring and Key Molecular Mechanisms. Biomolecules, 11.","DOI":"10.3390\/biom11050692"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"2805","DOI":"10.1007\/s00268-010-0778-8","article-title":"Adhesion awareness: A national survey of surgeons","volume":"34","author":"Schreinemacher","year":"2010","journal-title":"World J. Surg."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1111\/j.1463-1318.2007.01360.x","article-title":"Practicalities and costs of adhesions","volume":"9","author":"Wilson","year":"2007","journal-title":"Colorectal Dis."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1007\/s10397-012-0764-2","article-title":"Prevention of adhesions in gynaecological surgery: The 2012 European field guideline","volume":"9","author":"Koninckx","year":"2012","journal-title":"Gynecol Surg."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Sikirica, V., Bapat, B., Candrilli, S., Davis, K., Wilson, M., and Johns, A. (2011). The inpatient burden of abdominal and gynecological adhesiolysis in the US. BMC Surgery, 11.","DOI":"10.1186\/1471-2482-11-13"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1016\/S0002-9378(99)70205-X","article-title":"Adhesion-related small-bowel obstruction after gynecologic operations","volume":"180","author":"Platt","year":"1999","journal-title":"Am. J. Obstet. Gynecol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"e104","DOI":"10.1016\/j.jviscsurg.2011.11.006","article-title":"Post-operative adhesions after digestive surgery: Their incidence and prevention: Review of the literature","volume":"149","author":"Gaujoux","year":"2012","journal-title":"J. Visc. Surg."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1619","DOI":"10.1007\/s11605-010-1189-8","article-title":"The incidence and risk factors of post-laparotomy adhesive small bowel obstruction","volume":"14","author":"Barmparas","year":"2010","journal-title":"J. Gastrointest. Surg."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1476","DOI":"10.1016\/S0140-6736(98)09337-4","article-title":"Adhesion-related hospital readmissions after abdominal and pelvic surgery: A retrospective cohort study","volume":"353","author":"Ellis","year":"1999","journal-title":"Lancet"},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Practice Committee of American Society for Reproductive Medicine in collaboration with Society of Reproductive Surgeons (2013). Pathogenesis, consequences, and control of peritoneal adhesions in gynecologic surgery: A committee opinion. FertilSteril, 99, 1550\u20131555.","DOI":"10.1016\/j.fertnstert.2013.02.031"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"2004","DOI":"10.1681\/ASN.2006111292","article-title":"Epithelial to mesenchymal transition and peritoneal membrane failure in peritoneal dialysis patients: Pathologic significance and potential therapeutic interventions","volume":"18","author":"Aroeira","year":"2007","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Diamond, M.P., El-Hammady, E., Wang, R., Kruger, M., and Saed, G. (2004). Regulation of expression of tissue plasminogen activator and plasminogen activator inhibitor-1 by dichloroacetic acid in human fibroblasts from normal peritoneum and adhesions. Am. J. Obstet. Gynecol., 190.","DOI":"10.1016\/j.ajog.2004.02.009"},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Bove, G.M., Chapelle, S.L., Hanlon, K.E., Diamond, M.P., and Mokler, D.J. (2017). Attenuation of postoperative adhesions using a modeled manual therapy. PLoS ONE, 12.","DOI":"10.1371\/journal.pone.0178407"},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Bove, G.M., and Chapelle, S.L. (2012). Visceral mobilization can lyse and prevent peritoneal adhesions in a rat model. J. Bodyw. Mov. Ther., 16.","DOI":"10.1016\/j.jbmt.2011.02.004"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"4545","DOI":"10.3748\/wjg.v17.i41.4545","article-title":"Pathophysiology and prevention of postoperative peritoneal adhesions","volume":"17","author":"Arung","year":"2011","journal-title":"World J. Gastroenterol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1007\/s10397-012-0741-9","article-title":"Seprafilm(R) adhesion barrier: (1) a review of preclinical, animal, and human investigational studies","volume":"9","author":"Diamond","year":"2012","journal-title":"Gynecol. Surg."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Farquhar, C., Vandekerckhove, P., Watson, A., Vail, A., and Wiseman, D. (2000). Barrier agents for preventing adhesions after surgery for subfertility. Cochrane Database Syst. Rev., 2.","DOI":"10.1002\/14651858.CD000475"},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Berdah, S.V., Mariette, C., Denet, C., Panis, Y., Laurent, C., Cotte, E., Huten, N., Feuillet, E.L.P., and Duron, J.-J. (2014). A multicentre, randomised, controlled trial to assess the safety, ease of use, and reliability of hyaluronic acid\/carboxymethylcellulose powder adhesion barrier versus no barrier in colorectal laparoscopic surgery. Trials, 15.","DOI":"10.1186\/1745-6215-15-413"},{"key":"ref_21","unstructured":"EMA\/CHMP\/349968\/2015 Committee for Medicinal Products for Human Use (CHMP) 18 December 2014 (2022, July 28). European Medicine Agency. Available online: https:\/\/www.ema.europa.eu\/en\/documents\/variation-report\/xiapex-h-c-2048-ii-0044-epar-assessment-report-variation_en.pdf."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"513","DOI":"10.1177\/1753193420903624","article-title":"A systematic review identifying outcomes and outcome measures in Dupuytren\u2019s disease research","volume":"45","author":"Karpinski","year":"2020","journal-title":"J. Hand Surg. Eur. Vol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1055","DOI":"10.1111\/iwj.12760","article-title":"Enzymatic debridement with collagenase in wounds and ulcers: A systematic review and meta-analysis","volume":"14","author":"Patry","year":"2017","journal-title":"Int. Wound J."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"2069","DOI":"10.1021\/acs.molpharmaceut.8b00319","article-title":"Digesting a Path Forward: The Utility of Collagenase Tumor Treatment for Improved Drug Delivery","volume":"15","author":"Dolor","year":"2018","journal-title":"Mol. Pharm."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Garc\u00eda-Olmo, D., Villarejo Campos, P., Barambio, J., Gomez-Heras, S.G., Vega-Clemente, L., Olmedillas-Lopez, S., Guadalajara, H., and Garcia-Arranz, M. (2021). Intraperitoneal collagenase as a novel therapeutic approach in an experimental model of colorectal peritoneal carcinomatosis. Sci. Rep., 11.","DOI":"10.1038\/s41598-020-79721-0"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1159\/000444807","article-title":"Platelet Interaction with Innate Immune Cells","volume":"43","author":"Kral","year":"2016","journal-title":"Transfus. Med. Hemother."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1016\/j.bbrc.2020.12.012","article-title":"High-efficient generation of natural killer cells from peripheral blood with preferable cell vitality and enhanced cytotoxicity by combination of IL-2, IL-15 and IL-18","volume":"534","author":"Liu","year":"2021","journal-title":"Biochem. Biophys. Res. Commun."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Lai, C., Zhang, S.J., Chen, X.C., Sheng, L.Y., Qi, T.W., and Yan, L.P. (2021). Development of a cellulose-based prosthetic mesh for pelvic organ prolapse treatment: In vivo long-term evaluation in an ewe vagina model. Mater. Today Bio., 12.","DOI":"10.1016\/j.mtbio.2021.100172"},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Ribeiro, W.G., Nascimento, A.C.C., Ferreira, L.B., Marchi, D.D.D., Rego, G.M., Maeda, C.T., Silva, G.E.B., Neto, R.A., Torres, O.J.M., and Pitombo, M.B. (2021). Analysis of tissue inflammatory response, fibroplasia, and foreign body reaction between the polyglactin suture of abdominal aponeurosis in rats and the intraperitoneal implant of polypropylene, polypropylene\/polyglecaprone and polyester\/porcine collagen meshes. Acta Cir. Bras., 36.","DOI":"10.1590\/acb360706"}],"container-title":["Biology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2079-7737\/11\/8\/1159\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:01:27Z","timestamp":1760140887000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2079-7737\/11\/8\/1159"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,8,2]]},"references-count":29,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2022,8]]}},"alternative-id":["biology11081159"],"URL":"https:\/\/doi.org\/10.3390\/biology11081159","relation":{},"ISSN":["2079-7737"],"issn-type":[{"value":"2079-7737","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,8,2]]}}}